The possibility of dental implants in patients with fibrous dysplasia

Fibrozna displazija pripada fibroosealnim lezijama. To su benigne promjene karakterizirane zamjenom normalne, zdrave kosti s novoformiranim fibroznim vezivnim tkivom. Može doći u monoostotskom, poliostotskom obliku i u sklopu McCune-Albright sindroma. Ovisno o tipu bolesti simptomi mogu varirati, a sukladno s tim i izbor terapije. U tekstu se opisuje slučaj ugradnje dentalnih implantata kod pacijentice koja ima fibroznu displaziju, a naglasak je na problematici i pristupu zahvata ugradnje dentalnih implantata kod fibrozne displazije. Prikazan je slučaj pacijentice, koja se javlja sa željom za nadomjeskom izgubljenih zubi i ljepšim osmijehom. Pregledom ortopantomograma bile su vidljive koštane promjene u donjoj čeljusti. Daljnjom dijagnostičkom obradom CBCT-om i biopsijom utvrđeno je da promjene odgovaraju dijagnozi fibrozne displazije. Ekstrahirani su zubi 36, 37 i planirana je ugradnja dentalnih implantata na pozicije 46, 36. Manji broj pretražene literature prikazuje slične slučajeve koji uspješno liječe bezubost implanto-protetskom terapijom kod bolesnika s fibroznom displazijom. Uz informiranje i pristanak pacijentice postavljeni su implantati u regiju 46 i 36, Bego Semados implantat 4,1 x 11.5 mm u područje 46, s izmjerenom ISQ vrijednosti 83,87. U područje 36 postavljen je Bego Semados dentalni implantat 4,1 x 7 mm. Nakon šest mjeseci otvoreni su implantati i postavljeni gingivaformeri za oblikovanje gingive. Izmjerena stabilnost implantata je bila ISQ 46 – 74, ISQ 36 – 84. Mjesec dana nakon cijeljenja i oblikovanja gingive izrađene su keramičke krunice te učinjen kontrolni ortopantomogram. Na temelju kliničkog praćenja implantati su oseointegrirani i stavljeni u funkciju, a pacijentica je bila zadovoljna ishodom terapije.Fibrous dysplasia is a form of fibro-osseous lesion. It refers to benign changes characterised by the replacement of normal bone structure with newly formed fibrous connective tissue. It can be in monostotic or polyostotic form and as a feature of McCune-Albright syndrome. The symptoms can vary depending on the form of the disease and thus the type of therapy. This text describes a case where a patient with fibrous dysplasia has received dental implants. Furthermore, the focus is on the issues and approach of the procedure of dental implementation in patients with fibrous dysplasia. The particular case refers to a female patient who wanted to resolve issues of missing teeth and embellish her smile. The orthopantomogram showed bone changes in the lower jaw. Further diagnosis using CBCT and biopsy proved that these changes were features of fibrous dysplasia. Two teeth (#36 and 37) were extracted and dental implants were placed on positions #46 and 36. There are only a few cases reported where patients with fibrous dysplasia were successfully treated with implant-prosthetic therapy. With the informed consent from the patient, two implants were placed; Bego Semados implant (4,1x11.5mm) in the region of tooth #46 with measured ISQ value of 83-87, and Brego Semados implant (4,1x7mm) in the region of tooth #36. After six months, the implants were opened and gingiva formers were placed. Implant stability was measured and the values were ISQ 46-74 and ISQ 36-84. Ceramic dental crowns were made one month after healing and the formation of gingiva. In addition, an orthopantomogram was made as a checkup. Based on clinical monitoring, the implants were osseointegrated and fully functional. The patient was pleased with the outcomes of the therapy